Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain andmorphine consumption after laparoscopic\nsurgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and\ndose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods.\nPatients were randomized to receive 50, 100, or 150mg of ropivacaine 1% by peritoneal nebulization through a nebulizer.Morphine\nconsumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse\neffects were collected during the first 48 hours after surgery. The pharmacokinetics of ropivacaine was evaluated using high\nperformance liquid chromatography. Results. Nebulization of 50 mg of ropivacaine had the same effect of 100 or 150 mg in terms\nof postoperative morphine consumption, shoulder pain, postoperative nausea and vomiting, activity resumption, and hospital\ndischarge timing (>0.05). Plasma concentrations did not reach toxic levels in any patient, and no significant differences were\nobserved between groups (
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